Sexual Orientation Group Differences in Perceived Stress and Depressive Symptoms Among Young Adults in the United States

Purpose: Overall, sexual minorities have poorer mental health than heterosexual individuals, and stress is thought to underlie such disparities. However, sexual minorities include both those identifying as lesbian, gay, or bisexual (LGB) and many who do not (e.g., individuals identifying as mostly heterosexual, or as heterosexual but with discordant same-sex attractions or behaviors), and little is known about the mental health or stress experiences of non-LGB identified sexual minorities. This study assessed perceived stress and depressive symptom differences between concordant heterosexual individuals and three groups of sexual minority young adults (LGB, mostly heterosexual, and discordant heterosexual individuals). Methods: Data were from the National Longitudinal Study of Adolescent to Adult Health, Wave IV (2008-2009). Descriptive and bivariate statistics were estimated. Path analyses assessed whether perceived stress mediated differences in depressive symptomatology. Analyses were weighted and gender-stratified. Results: Mostly heterosexual individuals comprised the largest sexual minority group, for both men (3.58%) and women (15.88%). All sexual minority groups reported significantly more depressive symptoms than concordant heterosexual individuals, for both men and women (all P<0.05). Among women, all sexual minority groups reported significantly higher perceived stress than concordant heterosexual individuals (all P<0.05), which partially mediated elevations in depressive symptomatology (all P<0.05). Mostly-heterosexual-identified men reported significantly higher perceived stress than concordant heterosexual men (P<0.01), which partially mediated elevations in depressive symptomatology (P<0.01). Conclusions: Our results underscore the importance of assessing sexual orientation comprehensively to fully understand sexual minority health disparities. Additional research should examine the stressors specific to different sexual minority groups.